| NPI | 1538991989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE JEAN RAVECH Chief Managed Care Officer 860-305-6640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2025-04-24 |